Treating a Self-Abusive Child
By Donna Engelgau
Dr. Rob, a family physician who has treated self-abusive teens, offers the following insights and advice on cutting, an increasingly common condition that affects some 10 percent of American teenage girls.
Q: What are some of the short and or/long-term health implications associated with children who repeatedly cut themselves?
A: There can be, and often are, many health concerns that affect people who self-harm by, among other things, cutting. To begin with, the short-term physical problems include infection, bruising, delayed or impaired healing and, of course, scarring. This is in addition to the psychological pain that these folks are experiencing, which often includes embarrassment, shame and guilt. In the long-term, scarring, which may not be totally correctable by plastic surgery, may be an end result. These scars will serve as permanent reminders of the pain that caused them to self-injure in the first place.
Q: What's the prognosis for kids who self-abuse?
A: The prognosis varies depending upon the emotional or psychological state that caused the person to self-injure. That's why it's so very important to determine the factors that led to the behavior, including family or social issues, such as abandonment or sexual abuse, as well as any pre-existing personality disorders that need to be identified and treated.
Q: Are we starting to see an increase in teen self-abuse, or is the subject now more in the open?
A: I believe we are seeing more incidences of self-abuse mainly because there are more children now than 20 or even 10 years ago. Combine this with an increased awareness among health-care professionals, and we have an environment where more people who self-injure are coming forward and are being identified and helped. I also believe the Internet plays an important role, especially for teenagers as they are able to get more information to either help themselves, or their friends.
Q: Are there any studies to suggest why girls are more prone than boys to self-abuse?
A: There are multiple studies that state self-abuse is more common in girls than boys, but the exact reasons are unclear. There is a common belief that boys seem to be able to suppress their feelings and put them aside, at least for a while as younger adults. Girls, however, often deal with their emotions and let them out in some manner. It can either be constructive, or in the case of self-injury, destructive.
Q: How would you advise a parent who has just discovered that his daughter is cutting herself?
A: Please, please do not judge or blame your child for what has happened. It's so very important to try and listen — to really hear what they have to say. Your child is in a lot of psychological pain and is trying desperately to deal with it. Just hug them if they will let you, or sit by their side. The first things to say are: "I am so sorry you are going through this. You must be hurting so very badly inside, and no matter what has happened in the past, I am your parent and I love you. What can I do to help?" Parents, now is the time to put away all your thoughts about what is best for you. It is a time to get to the best professionals in your area who work with children who self-abuse. Do your homework, call a local support group, talk to your child's pediatrician and/or local social-service professional for recommendations for health-care professionals who can help your child. This is a time for you to offer guidance to your child —
not discipline or punishment.
Robert Danoff, D.O., M.S., is a family physician. He is program director of Family Practice Residency Frankford Hospitals, Jefferson Health System, Philadelphia, Pa. He also is a medical correspondent for The Comcast Network, CN8, contributing writer to the New York Times and writes a weekly medical column for the Bucks Courier Times, Bucks County Pa.
